Background: Antibiotics are frequently prescribed—and overprescribed—at hospital discharge, leading to adverse-events and patient harm. Antibiotic overuse at discharge varies widely across hospitals, with rates of overuse differing up to 5-fold.(1) Our understanding of what approaches optimize prescribing at discharge is limited. Recently, we published the ROAD (Reducing Overuse of Antibiotics at Discharge) Home Framework which […]

Background: Previous studies have documented discriminatory refusals from post-acute care facilities related to opioid use disorder or opioid agonist therapy, however the impact of inability to secure skilled nursing facility (SNF) placement for patients with any substance use disorder (SUD) has not been fully explored. The objective of this study is to measure the odds […]

Background: Patients discharged from the hospital often face challenges accessing timely and effective follow-up care after discharge from the inpatient setting. Prior studies have demonstrated that lack of primary care clinic access can raise patients’ risk of readmission (1, 2). Effectiveness of a virtual transitions of care clinic has not been reported in the literature […]

Background: The Centers for Medicare & Medicaid Services (CMS) uses a five‐star quality rating system to measure Medicare beneficiaries’ experience with their health care system. Unplanned readmission rates serve as a marker of the effectiveness and safety of its transitional care process and carry significant weight in determining a hospital’s overall rating. Our institution, an […]

Background: Hospital throughput and length of stay (LOS) are important drivers of success in an increasingly competitive healthcare landscape where revenues are down and demand can exceed hospital capacity. More specifically, longer LOS and hospital throughput bottlenecks impact access to timely care, the quality and safety of care delivery, patient and family satisfaction, and provider […]

Background: Readmissions are costly to the healthcare system have been associated with low patient satisfaction scores, longer length of stay, and higher mortality. Identifying and addressing patient needs at the time of transitioning care from the inpatient to outpatient setting has the potential to reduce readmission rates. The purpose of our project was to develop […]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care, such as errors in communication and gaps in information transfer. In our prior work evaluating IHT to general medical (GMS), cardiology, oncology and ICU services at an 800-bed tertiary care referral hospital, we found that in 37% […]

Background: Treatment of complicated urinary tract infections (cUTI), including acute pyelonephritis (AP) due to multi-drug resistant (MDR) Gram-negative uropathogens (e.g., extended-spectrum ß-lactamase (ESBL)-producing and fluoroquinolone-resistant strains) is associated with poor outcomes and increase costs of care. In the setting of limited alternative oral options, patients with cUTI/AP are commonly hospitalized to receive intravenous (IV) antibiotic […]

Background: In 2017, Emory University Hospital Midtown (EUHM) instituted fast track dialysis (FTD) which identified low risk patients in the emergency department (ED) in need of hemodialysis (HD) and provided it efficiently. The FTD development team consisted of hospital medicine, emergency medicine, nephrology, dialysis unit nursing, and ED nursing. This program showed a reduction in […]

Background: Communication related to medications is an important metric on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure patient experience after discharge from the hospital. There are many factors which can lead to poor communication about medications (Figure 1). Over 20% of readmissions can be related to medications, and of […]